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系统性红斑狼疮患者感染后入住重症监护病房的临床表现和结局。

Clinical presentations and outcomes of systemic lupus erythematosus patients with infection admitted to the intensive care unit.

机构信息

Division of Rheumatology, Cooper Medical School of Rowan University, USA.

出版信息

Lupus. 2013 Jun;22(7):690-6. doi: 10.1177/0961203313490240. Epub 2013 May 20.

Abstract

OBJECTIVE

The objective of this article is to investigate clinical presentations and outcomes of systemic lupus erythematosus (SLE) patients with infection admitted to the intensive care unit (ICU).

METHODS

SLE patients with infection, SLE patients with noninfectious causes, and non-SLE patients with infection were identified from the Cooper University Hospital Project IMPACT database between 2002 and 2010. We examined demographic data, APACHE II scores, physiologic data, laboratory data, length of stay in the ICU and hospital, and mortality of the three groups.

RESULTS

Twenty-five SLE patients with infection, 45 SLE patients with noninfectious causes, and 1466 non-SLE patients with infection were included in the study. SLE patients with infection had higher APACHE II scores, higher maximum temperature, higher minimum and maximum heart rate (HR), lower minimum and maximum systolic blood pressure (SBP), and longer ICU length of stay in comparison to SLE patients with noninfectious causes. There were no statistical differences in white blood cell (WBC) count. SLE patients with infection had a higher mortality compared to SLE patients with noninfectious causes. There was no difference in mortality between SLE patients with infection and non-SLE patients with infection.

CONCLUSION

SLE patients with infection in the ICU had a higher mortality and a higher APACHE II score compared to SLE patients with noninfectious causes in the ICU. Their physiologic signs including temperature, HR, and SBP were more reflective of infection than their WBC count.

摘要

目的

本文旨在研究因感染而入住重症监护病房(ICU)的系统性红斑狼疮(SLE)患者的临床表现和结局。

方法

我们从 2002 年至 2010 年期间 Cooper 大学医院项目 IMPACT 数据库中确定了感染的 SLE 患者、非感染性病因的 SLE 患者和感染的非 SLE 患者。我们检查了三组患者的人口统计学数据、急性生理与慢性健康状况评分系统 II(APACHE II)评分、生理数据、实验室数据、ICU 和住院时间以及死亡率。

结果

本研究纳入了 25 例感染的 SLE 患者、45 例非感染性病因的 SLE 患者和 1466 例感染的非 SLE 患者。与非感染性病因的 SLE 患者相比,感染的 SLE 患者的 APACHE II 评分更高,体温更高,最大和最小心率(HR)更高,最大和最小收缩压(SBP)更低,ICU 住院时间更长。白细胞(WBC)计数无统计学差异。感染的 SLE 患者的死亡率高于非感染性病因的 SLE 患者。感染的 SLE 患者与感染的非 SLE 患者的死亡率无差异。

结论

与非感染性病因的 SLE 患者相比,感染的 SLE 患者在 ICU 中的死亡率更高,APACHE II 评分更高。他们的生理指标,包括体温、HR 和 SBP,比 WBC 计数更能反映感染。

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